Compared to the AChR-MG and AChR+LRP4-MG groups, patients in the AChR+Titin-MG group tended to have shorter conversion times from ocular to generalized MG (5.14 ± 0.0 vs. 11.69 ± 0.0 and 13.08 ± 0.5 months; P < 0.001), Furthermore, AChR+Titin-MG patients had greater bulbar dysfunction, higher incidences of thymoma (32.8 vs. 19.8 and 3.4%; P = 0.006), and more severe QMG scores [15.5 (11.75–22.5) vs. 13 (8–19) in AChR-the MG group (P=0.005), and 9 (6–14) in the AChR+LRP4-MG group (P < 0.001)]. This evidence concerns the gene MGAM and thymoma.